Toxin ingestion is a significant public health issue for children, accounting for hundreds of visits per day to emergency departments. The most common substances are household cleaning products, personal care products, and medications. This article describes an ingestion of a rare substance called strychnine, which is a plant-based odorless powder that was previously used as a nonspecific stimulant. This toxicity can mimic other ingestions, thus delaying diagnosis, so an increased awareness of the common symptoms and laboratory findings may lead to a more targeted management of strychnine poisoning. [ Pediatr Ann. 2019;48(5):e205–e207.]

Immune- mediated encephalitis is the most common cause of encephalitis after infection in children and adults. Although this disease process was identified nearly 20 years ago, the variety of clinical presentations and the lack of specific diagnostic criteria can make the identification of anti-N-methyl-D-aspartate receptors (NMDA-R) encephalitis challenging. Moreover, identifying NMDA-R antibodies in blood or cerebrospinal fluid can take days to weeks, and thus clinicians need to have a high index of suspicion to investigate for this disease in patients who may appear to have an overlap of neurologic and psychiatric symptomatology. In this article, the authors describe three illustrative cases of anti-NMDA-R encephalitis in children age 3 to 16 years. The discussion reviews our current understanding of the clinical presentation, diagnostic criteria, and inpatient therapeutic management of anti-NMDA-R encephalitis, as well as illuminates the unique and often perplexing presentations of this disease process versus other organic and psychiatric causes of altered mental status. [ Pediatr Ann. 2019;48(10):e387–e390.]

Objective: This study explores whether nominal demographics, symptoms, signs and laboratory predictors can determine a perforated appendix in pediatric population at an urban community hospital.Methods: A retrospective analysis was performed including variables such as demographics, clinical signs, symptoms and laboratory predictors. The patient population consisted of all children between the ages of 0 and 18 years who were treated for acute appendicitis between January 2014-December 2014. Patients with perforated appendicitis were identified using coding data.Results: During the 1-year period, 74 patients were treated for appendicitis. Using correlation and logistic regression, nineteen variables were assessed for any relationship to a ruptured appendix in these patients. No substantial correlations were detected. Conclusions:There have been reports of racial and socioeconomic disparities with regards to perforated appendicitis in children. However, there is not enough evidence in the literature that supports the prediction of perforated appendix based on clinical and laboratory values. This study, at Saint Anthony Hospital, found no correlation between socioeconomic status, clinical presentation, laboratory values and ruptured appendix.

Pediatric demyelinating syndromes are a spectrum of diseases affecting the central nervous system. In the past decade, major advances have been made in this field, including the discovery of antibody-based biomarkers and treatment guidelines for specific syndromes. When myelin oligodendrocyte glycoprotein (MOG) antibodies were first discovered, they were thought to be a biomarker for multiple sclerosis (MS). However, further research has shown that MOG positivity during the first episode of a pediatric demyelinating syndrome is a predictor of a course that is distinct to MS. This article discusses the clinical manifestations of MOG antibody associated disease and key distinguishing features in the investigation, treatment, and prognosis between MOG and other demyelinating diseases. [ Pediatr Ann . 2021;50(6):e254–e258.]